SlideShare uma empresa Scribd logo
1 de 74
Baixar para ler offline
3 important Antibiotics
Cephalosporin
Tetracyclines&
Fluoroquinolones
Presented by:
Md.Mustahasin Karim
Cephalosporin
 Cephalosporins are grouped into "generations" by their
antimicrobial properties. Cephalosporins are categorized
 chronically, and are therefore divided into first, second,
and third generations. Currently, three generations of
 cephalosporins are recognized and a fourth has been
proposed. Each newer generation of cephalosporins has
 greater gram negative antimicrobial properties than the
preceding generation. The later-generation
 cephalosporins have greater effect against resistant
bacteria.
Cephalosporin
 Cephalosporins are beta-lactam compounds in which the
beta-lactam ring is fused to a 6-membered dihydrothiazine
ring, thus forming the cephem nucleus. Side chain
modifications to the cephem nucleus confers 1)an
improved spectrum of antibacterial activity,2)
pharmacokinetic advantages, and 3) additional side effects.
Based on their spectrum of activity, cephalosporin's can be
broadly categorized into four generations.
Structure:
Cephalosporin
Mechanism of action:
 Cephalosporins are bactericidal and have the same mode of
action as other beta-lactam antibiotics (such as penicillins)
but are less susceptible to penicillinases. Cephalosporins
disrupt the synthesis of the peptidoglycan layer of bacterial
cell walls. The peptidoglycan layer is important for cell wall
structural integrity. The final transpeptidation step in the
synthesis of the peptidoglycan is facilitated by
transpeptidases known as penicillin-binding proteins
(PBPs). PBPs bind to the D-Ala-D-Ala at the end of
muropeptides (peptidoglycan precursors) to crosslink the
peptidoglycan. Beta-lactam antibiotics mimic(অনুকরণপ্রিয়)
the D-Ala-D-Ala site, thereby irreversibly inhibiting PBP
crosslinking of peptidoglycan.
CLASSIFICATION
A. First Generation
 Cephaloridine-Loridine, Ceporan
 Cephalothin-Keflin
 Cephalexin-Keflex, Ceporex
 Cefazolin-Cefacidal
 Cephradine-Velosef
 Cepharpirin-Cefadyl
 Cephadroxil-Doricef, Cefamox
Second Generation
 Cefaclor-Ceclor
 Cefoxitin – Mefoxin
 Cefuroxime – Zinacef, Zinnat
 Cefonicid – Monocid
 Cefotetan - Cefotan
 Cefamdandole – Mandol
 Cefprozil – Cefzil
 Loracarbef – Lorabid
 Cefmetazole – Zefazone
 Ceforanide
Third Generation
 Cefotaxime – Claforan
 Cefoperazone – Cefobid
 Moxolactam – Moxam
 Ceftizoxime – Cefizox
 Ceftriaxone – Rocephin
 Ceftazidime – Fortum
 Cefotiam – Ceradolan
 Cefixime – Suprax
 Cefetamet – Globocef
 Cefpodoxime – Vantin
 Ceftibuten – Cedax
 Cefdinir –Omnicef
 Cefditoren
Fourth Generation
Cefepime – Maxipime
Cefpirome – Cefrom
CEFADROXIL
Indication:
 It has been successfully used for the treatment of upper
respiratory tract infection.
 It is also used in U.T.I.
 Community acquired pneumonia(প্রনয়য়োয় োপ্রনয়ো) is well
treated by cefadroxil.
 It is effective against Gram-positive and Gram-negative
organisms.
 Contraindication:
 It is not used in an individuals with porphyria(rare inherited
or acquired disorder).
 If the patient hypersensitive to cephalosporin.
 Adverse effect:
 Diarrhoea.
 Nausea , Vomiting.
 Allergic reaction may occur.
 Blood disorders; including
thrombocytopenia(abnormally low amount of platelets).
 Leucopenia(Decrease of white blood cell).
 Aplastic anemia(damage of bone marrow).
Dose:
 Adult:
500mg twice daily for skin, soft tissue and U.T.I.
 Child:
250mg twice daily , soft tissue and U.T.I.(Age: 1-6 years).
Brand Name:
 Adora – Incepta.
 Trubid –Opsonin.
 Arocef –SK₊F.
CEFALEXIN/CEPHALEXIN
Indication:
 It has highly activity against Gram-positive organisms and
moderate activity against Gram-negative organism such as E.coli
, Klebseilla and proteus.
 It is useful for U.T.I. and R.T.I.
 It is effective in Sinusitis and Skin and Soft tissue infection.
Contraindication:
 It should not be used in infection caused by H. influenza.
 It should not used in Syphilis(sexually transmitted infection).
 Cephalosporin hypersensitivity.
Adverse effect:
 Diarrhea, Vomiting.
 Abdominal discomfort are relatively common.
 Neurological disturbances may occur rarely.
Dose:
 Adult:
500mg twice daily for severe infection.
 Child:
250mg twice daily for U.T.I.
Prophylaxis of recurrent U.T.I , 125mg at night.
Brand Name:
 Ceporin – Square.
 Keflin – Opsonin.
 Alexin – Reneta.
CEFOXITIN
Indication:
 It is effective against betalactamase producing strains of
Haemophilus influenzae.
 It is effective against Gram-negative organisms , except
pseudomonas.
 It can also be used in the treatment of U.T.I and lower respiratory
tract infections.
 It is useful in otitis ( কোয়নর িদোহ) media.
Contraindication:
 Hypersensitive to cephalosporin.
 Porphyria.
Adverse effect:
 Diarrhea.
 Nausea , Vomiting.
 Allergic reaction may also occur.
 GI upset.
Dose:
 200 – 400 mg daily in 1-2 divided dose.
 Brand Name:
 Cef-3−Square.
 Cefid−Opsonin.
 Rokim−SK₊F
CEFDINIR
Indication:
 It is very active against Staphylococci , Streptococci and H.
influenza.
 It is used in the treatment of gonrrhoea ( sexuall
transmitted infections).
 It is also used in R.T.I.
Contraindications:
 Hypersensitive to cephalosporin.
 Porphyria.
Adverse effect:
 Diarrhea.
 Allergic reaction.
 Gastrointestinal upset.
 Uncomfortable abdomen.
Dose:
 200-400mg daily in 1-2 divided doses.
 Brand Name:
 Efdinir-Incepta.
 Cednir-SK₊F.
 Cefida-Beximco.
CEFOTAXIME
Indication:
 It is widely used in in respiratory infection.
 It is effective in meningitis( প্রিষ্ক প্রিল্লীর িদোহ).
 It is used in the treatment of Typhoid fever , U.T.I.
 It is useful in gonorrhoea and intra-abdominal sepsis.
Contraindication:
 Hypersensitive to cephalosporin.
 Porphyria.
Adverse effect:
 Dermatological problem.
 Hematological problem may occur.
 Diarrhea.
 Allergic reaction.
Dose:
 I.M,I.V 1-2g every 8hours depends on severity of infection.
Brand Name:
 Cefotax – Renata.
 Maxcef – Square.
 Taxim – Acme.
CEFPODOXIME
Indications:
 It is used in upper respiratory tract infection.
 It is used in the treatment of lower respiratory tract
infection including bronchitis , pneumonia , skin and soft
tissue infection.
 It is used in the treatment of gonorrhoea.
Contraindication:
 Cephalosporin sensitivity.
 Porphyria.
Adverse effect:
 GI upset.
 Diarrhea.
 Nausea , Vomiting.
 Allergic reaction also occur.
Dose:
 100-200mg every 12hours for R.T.I. and U.T.I.
Brand Name:
 Vanprox – Square.
 Vercef – Beximco.
 Ximeprox – Incepta.
 Cefdox – ACI.
CEFTRIAXONE(INJ.)
Indication:
 It is effective in uncomplicated gonorrhoea and genital
ulceration.
 It has been commanded for the treatment of enteric fever.
 It is also used in meningitis.
 It is used in osteomyelitis (অপ্রির িদোহ).
Contraindication:
 Cephalosporin sensitivity.
 Porphoria.
Adverse effect:
 Abdominal pain , Diarrhea.
 Rush , fever.
 Thrombocytopenia , thrombocytosis , leucopenia.
Dose:
 A single 250mg dose is effective for gonorrhoea and genital
ulceration.
 I.M , I.V 1 g/day as a single dose in moderate infaction.
Brand Name:
 Traxon – opsonon.
 Arixon – Baximco.
 Ceftron – Square.
 Axon – Aristopharma.
CEFEPIME(INJ.)
Indication:
 It is indicated for the treatment of serious infection due to
organism resistance to cefotaxime.
 It is used in the treatment of respiratory tract infection.
 It is useful in gonorrhoea.
 It is effective in enteric fever.
Contraindication:
 Hypersensitivity to cephalosporin.
 Porphyria.
Adverse effect:
 Allergic reaction occurs.
 Nausea , Vomiting.
 GI upset.
Dose:
 I.V 2g of cefepime is given over 30min.
Brand Name:
 Xenim – Opsonin.
 Ultrapime – Incepta.
 Ceftipime – Reneta.
MAFENIDE
Indication:
 It is used extensively in burns(second and third degree burn)
 It is bacteriostatic against many Gram-positive and Gram-
negative organisms.
 Its capacity to inhibit carbonic anhydrous which could
potentially result in metabolic acidosis(when body produce
much acid or when the kidney remove enough acid).
Contraindications:
 Renal impairment.
 Mefenide is contraindicated in those with sulfonamide
hypersensitivity.
Adverse effect:
 Super infection.
 Pain.
 Rash.
 Pruritus.
Dose:
 It should apply topically to a thickness of approx. 1.6mg to
cleaned and debrided wound once or twice per day.
Brand Name:
 Mafanil.
 Sulphamylar.
 Sulfamylon.
CEFTOBIPROLE
Indications:
 It is effective against MRSA.
 It is also used in the treatment of complicated skin and skin
structure infections.
 It gives better result in community –acquired pneumonia (it is
pneumonia acquired infectious from normal social
contact)compared to ceptriaxone.
Contraindications:
 Hypersensitivity to cephalosporin.
 Hepatic failure.
 Renal impairment.
Adverse effect:
 Nausea
 Diarrhea
 Allergic reaction.
Dose:
 400 mg daily for MRSA.
Brand Name:
 Zeftera-UK,EU
CEFTAROLINE FOSAMIL
Indications:
 It has activity against MRSA(Methicillin-resistant
Staphylococcus aureus)
 It is also used in treatment of complicated skin and skin
structure infections.
 It gives better result in community –acquired pneumonia
compared to ceftriaxone.
Contraindications:
 Known serious hypersensitivity to ceftarolin.
 Porphyria.
Adverse effect:
 Diarrhea.
 Nausea.
 Rush.
Dose:
 400mg daily for M.R.S.A.; in serve case it may be two time
daily.
Brand Name:
 Teflaro in US.
 Zinforo in Europe.
Tetracyclines
 - Tetracyclines are a group of broad-spectrum
antibiotics
 - They are natural product derived from
Streptomyces sp
 - Tetracyclines are so named for their four (tetra)
hydrocarbon rings
Tetracyclines
 - The general usefulness of tetracyclines has been
reduced with the onset of antibiotic resistance.
Despite this, they remain the treatment of choice for
some specific indications
General Consideration
- Source: Streptomyces grasius, a soil organism
- Spectrum: Broad spectrum of activity i.e., active
against both gm(+) and gm(-) bacteria
- Mode of action: Bacteriostatic in nature
- Mechanism of ACTION: Protein synthesis inhibition
History
 The development of the tetracycline antibiotics was
the result of a systemic screening of soil specimens
collected from many parts of the world for antibiotic-
producing microorganisms. The first of these
compounds chlortetracycline was introduced in 1948
followed by oxytetracycline and tetracycline in 1950
and 1952 respectively.
Types
 Tetracyclines are of two types:
 1. Natural Tetracycline: (Short acting)
- Chlortetracycline (S.aureofaciens )
- Oxytetracycline (S. rimosus )
- Demeclocycline (S. aureofaciens )
Types
 2. Semisynthetic Tetracycline: (long acting)
-Doxycyclicline
- Methecycline
- Minocycline
3. Both natural and semisynthetic:
-Tetracycline :
Natural from S. grasius
Semisynthetic from Chlortetracycline
Mechanism of ActionTetracycline
Enters into bacteria by
-passive diffusion
-Active transport
Binds reversibly to receptor on the 30s ribosomal subunit
Block the binding of charged aminoacyl tRNA to the ‘A’ site of the ribosome mRNA
complex
(-) addition of aminoacid in growing peptide chain
(-) Protein synthesis
(-) Bacterial growth & multiplication
Note: At high conc. they can inhibit protein synthesis of mammal cell
Mechanism of Tetracycline resistance
>>The drug is not actively transported into the cell
>>The drug leaves the cell so rapidly that the required
conc. Of the drug is not maintained
>>Enzymatic inactivation of tetracycline
>>Production of protein that interferes binding of
tetracycline to ribosome
Therapeutic uses
 Drug of first choice
●Rickettsial infection
-Rocky mountain spotted fever
-Typhus
-Rickettsialpox
●Mycoplasma infection
-Mycoplasma pneumonia
●Borrelia infection
-Lyme disease
-Relapsing fever
●Vibrio infection
-Cholera
●Plague, brucellois ( with aminoglycoside)
Therapeutic uses
 Drug of second choice
●Diarrhoea
●Dysentery
●Mixed bacterial infection e.g. repiratory tract infection
●Acne
●SIADH (Syndrome of inappropriate ADH secretion)
●Leptospiral infection
●Tularemia (An acute plague like infectious disease
Caused by Francisella tularensis transmitted to the human by
the bite of an infected tick or other blood sucking insect
●Weils disease
Adverse effect
 A) Organ/ system toxicity
●GIT
-Nausea
-Vomiting
-Diarrhoea
-Alteration of intestinal flora
● Hepatotoxicity
●Nephrotoxicity (due to inhibition of protein synthesis)
-Renal tubular acidosis
-Nephrogenic diabetes insipidus
-Fanconis syndrome
● Bony stucture and teeth:
-Discoloration and hypoplasia of teeth
●Vestibular toxicity:
-Dizziness
-Vertigo
Adverse effect
 B) Super infection:
-Candida or resistant staphylococci
 C) Hypersensitivity:
-Urticaria
-Anaphylaxix
-Angioedema
Contraindication
●Pregnancy and lactation
●Young children ( upto 8 years)
●Renal failure
●History of hypersensitivity
Oxytetracycline
● Indications:
-treatment of Spirochaetal infection.
-treatment of Non-Specific-Urethritis.
-treatment of Clostridial wound infection and Anthrax.
●Contraindication:
-Renal impairment
-Pregnancy & breast feeding
-SLE (Systemic lupus eryyhematosus)
●Side effects:
-Local irritation after intramuscular injection.
-Gastrointestinal:-anorexia, nausea, vomiting.
-Renal toxicity.
-Hypersensitivity reactions: Urticaria.
-Blood: Hemolytic anemia, thrombocytopenia, neutropenia
Oxytetracycline
●Dose:
250-500 mg every 6 hours
●Market preparations
-Renamycin® (Renata)
-Oxecylin® (ACME)
-Oxycap® (Globe Pharma)
Doxycycline
●Indications:
-Treatment of chronic adult periodontitis.
-Chronic prostatitis
-Brucellosis
●Contraindication:
-Renal impairment
-Pregnancy & breast feeding
-SLE (Systemic lupus eryyhematosus)
●Side effects:
-Watery diarrhea
-Bloody stools
-photosensitivity, rash
Doxycycline
●Dose:
-By mouth 200 mg on first day, then 100 mg daily
-In severe infections 200 mg daily for 4 days
●Market preparations:
-Doxin (Opsoni)
-Doxy-A (ACME)
-Servidoxyne (Novartis)
Tetracycline
●Indications:
-Tetracycline's primary use is for the treatment of acne
vulgaris and rosacea.
-It is also used to treat a very wide range of infections.
●Contraindication:
-Renal impairment
-Pregnancy & breast feeding
-SLE (Systemic lupus eryyhematosus)
●Side effects:
-Superinfection
-Enamel dysplasia
-Impairment in bone growth
Tetracycline
●Dose:
-By mouth 250 mg every 6 hours
-Increased in severe infections to 500 mg every 6-8 hours
●Market preparations:
-Jmycin (Jayson)
-Tetracycline (Opsonin)
-Tetracyn (Renata)
-Tetrax (Square)
Fluoroquinolones
 Fluoroquinolones are known as broad-spectrum antibiotics,
meaning they are effective against many bacteria.
 Fluoroquinolones are used to treat most common urinary tract
infections, skin infections, and respiratory
 infections (such as sinusitis, pneumonia, bronchitis). Common
side effects of fluoroquinolones include mainly
 the digestive system: mild stomach pain or upset, nausea,
vomiting, and diarrhea. These are usually mild and go
 away over time. Fluoroquinolones should not be given during
pregnancy.
 Fluoroquinolones inhibit bacteria by interfering with their
ability to make DNA. This activity makes it difficult
 for bacteria to multiply. This effect is bacteriocidal.
Quinolones
 The quinolones are family of synthetic broad spectrum
antibacterial drugs
 Quinolones exert their antibacterial effect by
preventing bacterial DNA fom unwinding and
duplicating
 The majority of quinolones in clinical use belong to
the subset fluroquinolones
History
 The first generation of quinolones began with the
introduction of nalidixic acid in 1962 for treatment of
urinary tract infections in humans. Nalidixic acid was
discovered by George Lesher and coworkers in a
distillate during an attempt at chloroquine synthesis.
Types
A) First generation:
●Non flurinated quinolone
●Narrow spectrum
-Nalidixic acid
B) Second generation:
● Flurinated quinolones, 6o times more active then nalidixic acid
●Broad spectrum
●Not effective against anaerobes and community acquired pneumonia caused by
Streptococcus pneumoniae
-Ciprofloxacin
-Enoxacin
-Lomefloxacin
-Acrosoxzacin
-Norfloxacin
-Ofloxacin
Types
C) Third generation:
●Broad spectrum
●Effective against anaerobes and community acquired pneumonia caused
by Streptococcus pneumoniae
-Sparfloxacin
-Levofloxacin
D) Fourth generation:
●More effective against anaerobes and community acquired pneumonia
caused by Streptococcus pneumoniae
-Moxifloxacin
-Trovafloxacin
Mechanism of Action
 Mechanism of action:
-Inhibit bacterial DNA synthesis by
inhibiting DNA gyrase and topo-isomerase
IV resulting to rapid cell death
-Post antibiotic effect: lasts 1 to 2
hours, increases with increasing
concentration
Mechanism of Action
Quinolone
Enter into cell via passive diffusion
(-) Rejoining of DNA
(-) Supercoiling of DNA
Cell death
Note: Quinolone (-) human DNA gyrase only at much higher
conc. i.e., 100-1000 µ gm/ml
Mechanism of Quinolone resistance
●Chromosomal:
-Alter target enzymes: DNA gyrase and topoisomerase IV
-Decreased drug penetration: Pseudomonas, E. coli
●Plasmid: seen in some K. pneumoniae and E. coli
●Mutations in both target enzymes are needed to produce significant
resistance
Therapeutic uses
●Urinary tract infections
●Gastrointestinal infections
-Enteric fever
-Bacillary dysentery
-Septicaemia
●Respiratory tract infections (but not in pneumococcal
pneumonia
●Gynecological infection
●Intraabdominal infection
●Severe systemic infection
Adverse effect
-Tendon inflammation
-Arthralgia
-Myalgia
-Hypersensitivity reactions (sometimes involving
blood cells
-Photosensitivity
-Nausea, Vomiting
Contraindication
-Epilepsy
-myasthenia gravis
-Pregnant and lactating women
-Children
Nalidixic acid
●Indications:
-In complicated UTI
●Contraindication:
-Hypersensitivity to drug
-Porphyria
-Liver disease
-Renal impairment
●Side effects:
-Psychosis
-Cranial nerve palsy
-Metabolic acidosis
Nalidixic acid
●Dose:
By mouth 1g every 6hours for 7 days
●Market preparations:
-Naligram® (ACME)
-Nebactil® (Beximco)
-Utirex® (Opsonin)
Ciprofloxacin
●Indications:
- Nosocomial pneumonia
- Intra-abdominal infections
-Uncomplicated/complicated UTI
-Anthrax exposure and prophylaxis
●Contraindications:
-Pregnant and lactating women
-myasthenia gravis
-Hypersensitivity
●Side effects:
-CNS toxicity
-GIT upset
-Hypersensitivity
Ciprofloxacin
●Dose
By mouth,
-In RTI 250-500 mg every 12 hours
-In pseudomonal lower RTI 750 mg twice daily
-In UTI 250-500 mg twice daily
●Market preparations:
-Beuflox (Incepta)
-Cipro-A (ACME)
-Flontin (Renata)
-Neofloxin XR (Beximco)
Lomefloxacin
●Indications:
-Treatment of bronchitis due to H. inflenzae
-UTI
●Contraindications:
-Pregnant and lactating women
-myasthenia gravis
-Hypersensitivity
●Side effects:
-Phototoxicity
-CNS toxicity
-GIT upset
-Hypersensitivity
Lomefloxacin
●Dose:
400 mg once daily
●Market preparations:
-Lomeflox (Aristopharma)
-Mexio (Square)
-Namicin (Nipa)
Ofloxacin
●Indications:
-UTI
-Lower RTI
-Gonrrhoea
-Cervicitis
●Contraindications:
-Hepatic and renal impairment
-History of psychiatric illness
●Side effects:
-Hypersensitivity reactions (sometimes involving
blood cells
Ofloxacin
●Dose:
By mouth,
-UTI: 200-400 mg daily in the morning. Increased
upto 400 mg twice daily for upper UTI
-Chronic prostatitis 200 mg twice daily for 28 days
-Lower RTI 400 mg daily in the morning
●Market preparations:
-Oflacin (Drug Intl.)
-Rutix (Square)
Levofloxacin
●Indications:
-Chronic bronchitis and CAP
- Nosocomial pneumonia
-SSTIs
-Intra-abdominal infections
●Contraindictions:
-Renal impairment
-Pregnant and lactating women
-Children
●Side effects:
-Asthenia
-Rarely tremor
-Anxiety
-Tachycardia
Levofloxacin
●Dose:
Oral,
-Acute sinusitis: 500mg daily for 10-14 days
- -Exacerbation of chronic bronchitis: 250-500 mg daily for 7-10 days
- -Community acquired pneumonia: 500 mg once or twice daily for
7-14 days
●Market preparations:
-Evo (Beximco)
-Exolev (Novartis)
-Levoking (Renata)
-Trevox (Square)
Moxifloxacin
●Indications:
-Chronic bronchitis
-Bacterial conjuctivitis
-Sinusitis
●Contraindications:
-Should be avoided in patients with existing QT prolongation
●side effects:
-CNS toxicity
-GIT upset
-Hypersensitivity
Moxifloxacin
●Dose:
Adult dose is 400 mg daily
●Market preparations:
-Maximox (Orion)
-Odycin (Beximco)
-Optimox (aristopharma)

Mais conteúdo relacionado

Mais procurados (20)

Laxatives purgatives
Laxatives purgativesLaxatives purgatives
Laxatives purgatives
 
Drug presentation on diazepam
Drug presentation on diazepam Drug presentation on diazepam
Drug presentation on diazepam
 
Pharmacology of Cephalosporins
Pharmacology of CephalosporinsPharmacology of Cephalosporins
Pharmacology of Cephalosporins
 
Frusemide
FrusemideFrusemide
Frusemide
 
Furosemide DRUG PROFILE
Furosemide DRUG PROFILEFurosemide DRUG PROFILE
Furosemide DRUG PROFILE
 
Ceftriaxone
CeftriaxoneCeftriaxone
Ceftriaxone
 
Ranitidine drug
Ranitidine drug Ranitidine drug
Ranitidine drug
 
Dexamethasone
Dexamethasone Dexamethasone
Dexamethasone
 
Drugs used for respiratory system
Drugs used for respiratory systemDrugs used for respiratory system
Drugs used for respiratory system
 
Antimalarial drugs
Antimalarial drugs Antimalarial drugs
Antimalarial drugs
 
Antidiarrheals drug
Antidiarrheals drugAntidiarrheals drug
Antidiarrheals drug
 
Mucolytic Drugs
Mucolytic Drugs Mucolytic Drugs
Mucolytic Drugs
 
Anti tubercular drugs
Anti tubercular drugsAnti tubercular drugs
Anti tubercular drugs
 
Omeprazole
OmeprazoleOmeprazole
Omeprazole
 
Urinary antiseptics
Urinary antisepticsUrinary antiseptics
Urinary antiseptics
 
Drugs used on respiratory system
Drugs used on respiratory systemDrugs used on respiratory system
Drugs used on respiratory system
 
Antimalarial drugs
Antimalarial drugsAntimalarial drugs
Antimalarial drugs
 
Salmeterol and fluticasone
Salmeterol and fluticasoneSalmeterol and fluticasone
Salmeterol and fluticasone
 
Urinary antiseptics
Urinary antisepticsUrinary antiseptics
Urinary antiseptics
 
Antiviral agents
Antiviral agentsAntiviral agents
Antiviral agents
 

Destaque

Cephalosporin
CephalosporinCephalosporin
Cephalosporinfaseeha94
 
Antibiotics course quinolones
Antibiotics course quinolonesAntibiotics course quinolones
Antibiotics course quinolonesmohamednassar1
 
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract Antiseptics
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract AntisepticsPharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract Antiseptics
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract AntisepticsAreej Abu Hanieh
 
Pharmacology of aminoglycosides and macrolides
Pharmacology of aminoglycosides and macrolidesPharmacology of aminoglycosides and macrolides
Pharmacology of aminoglycosides and macrolidesKoppala RVS Chaitanya
 
New generation Antibiotics /certified fixed orthodontic courses by Indian den...
New generation Antibiotics /certified fixed orthodontic courses by Indian den...New generation Antibiotics /certified fixed orthodontic courses by Indian den...
New generation Antibiotics /certified fixed orthodontic courses by Indian den...Indian dental academy
 
Cephalosporins 5th generation
Cephalosporins 5th generationCephalosporins 5th generation
Cephalosporins 5th generationFabio Grubba
 
104879609 drug-study-gbs
104879609 drug-study-gbs104879609 drug-study-gbs
104879609 drug-study-gbsJilbab Oke
 
The wonder drug --Quinolones.
The wonder drug --Quinolones.The wonder drug --Quinolones.
The wonder drug --Quinolones.dranjalivyas
 
Fifth generation cephalosporins 2011
Fifth generation cephalosporins 2011 Fifth generation cephalosporins 2011
Fifth generation cephalosporins 2011 PathKind Labs
 
Pharmacology - Principles of Antimicrobial therapy
Pharmacology -  Principles of Antimicrobial therapyPharmacology -  Principles of Antimicrobial therapy
Pharmacology - Principles of Antimicrobial therapyAreej Abu Hanieh
 
Pharmacology - Antimycobacterials Drugs
Pharmacology - Antimycobacterials DrugsPharmacology - Antimycobacterials Drugs
Pharmacology - Antimycobacterials DrugsAreej Abu Hanieh
 
Pharmacology - Cell wall inhibitors 1
Pharmacology - Cell wall inhibitors 1Pharmacology - Cell wall inhibitors 1
Pharmacology - Cell wall inhibitors 1Areej Abu Hanieh
 
Pharmacology - Cell wall inhibitors 2
Pharmacology  - Cell wall inhibitors 2Pharmacology  - Cell wall inhibitors 2
Pharmacology - Cell wall inhibitors 2Areej Abu Hanieh
 

Destaque (20)

Cephalosporin
CephalosporinCephalosporin
Cephalosporin
 
Antibiotics course quinolones
Antibiotics course quinolonesAntibiotics course quinolones
Antibiotics course quinolones
 
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract Antiseptics
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract AntisepticsPharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract Antiseptics
Pharmacology - Quinolones ,Folic Acids Antagonist ,and urinary tract Antiseptics
 
Pharmacology of aminoglycosides and macrolides
Pharmacology of aminoglycosides and macrolidesPharmacology of aminoglycosides and macrolides
Pharmacology of aminoglycosides and macrolides
 
Quinolones
QuinolonesQuinolones
Quinolones
 
New generation Antibiotics /certified fixed orthodontic courses by Indian den...
New generation Antibiotics /certified fixed orthodontic courses by Indian den...New generation Antibiotics /certified fixed orthodontic courses by Indian den...
New generation Antibiotics /certified fixed orthodontic courses by Indian den...
 
Cephalosporins 5th generation
Cephalosporins 5th generationCephalosporins 5th generation
Cephalosporins 5th generation
 
104879609 drug-study-gbs
104879609 drug-study-gbs104879609 drug-study-gbs
104879609 drug-study-gbs
 
The wonder drug --Quinolones.
The wonder drug --Quinolones.The wonder drug --Quinolones.
The wonder drug --Quinolones.
 
Fifth generation cephalosporins 2011
Fifth generation cephalosporins 2011 Fifth generation cephalosporins 2011
Fifth generation cephalosporins 2011
 
Pharmacology - Principles of Antimicrobial therapy
Pharmacology -  Principles of Antimicrobial therapyPharmacology -  Principles of Antimicrobial therapy
Pharmacology - Principles of Antimicrobial therapy
 
Antibiotics course. 1-Quinolones
Antibiotics course. 1-QuinolonesAntibiotics course. 1-Quinolones
Antibiotics course. 1-Quinolones
 
Eicosanoids
EicosanoidsEicosanoids
Eicosanoids
 
Pharmacology - Antimycobacterials Drugs
Pharmacology - Antimycobacterials DrugsPharmacology - Antimycobacterials Drugs
Pharmacology - Antimycobacterials Drugs
 
Cephalosporin
CephalosporinCephalosporin
Cephalosporin
 
Pharmacology - Cell wall inhibitors 1
Pharmacology - Cell wall inhibitors 1Pharmacology - Cell wall inhibitors 1
Pharmacology - Cell wall inhibitors 1
 
Pharmacology - Cell wall inhibitors 2
Pharmacology  - Cell wall inhibitors 2Pharmacology  - Cell wall inhibitors 2
Pharmacology - Cell wall inhibitors 2
 
60180538 case-study
60180538 case-study60180538 case-study
60180538 case-study
 
Antifungal agents
Antifungal agentsAntifungal agents
Antifungal agents
 
Pharmacology of Eicosanoid
Pharmacology of EicosanoidPharmacology of Eicosanoid
Pharmacology of Eicosanoid
 

Semelhante a Antibiotics(Cephalosporins • FluoroquinolonesTetracyclines)

Cephalosporins pharmacology presentation
Cephalosporins pharmacology presentationCephalosporins pharmacology presentation
Cephalosporins pharmacology presentationssuser504dda
 
Cephalosporins & other β lactam antibiotics
Cephalosporins & other β lactam  antibioticsCephalosporins & other β lactam  antibiotics
Cephalosporins & other β lactam antibioticsFarazaJaved
 
Cephalosporins penems
Cephalosporins  penemsCephalosporins  penems
Cephalosporins penemssuniu
 
cephalosporin-180714171228 (1). download
cephalosporin-180714171228 (1). downloadcephalosporin-180714171228 (1). download
cephalosporin-180714171228 (1). downloadNILESHVALVI3
 
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6rishi2789
 
Role Of Third And Fourth Generation Cephalosporin in ICU.pptx
Role Of Third And Fourth Generation Cephalosporin in ICU.pptxRole Of Third And Fourth Generation Cephalosporin in ICU.pptx
Role Of Third And Fourth Generation Cephalosporin in ICU.pptxRajsingh824183
 
cephalosporin-180714171228.pptx
cephalosporin-180714171228.pptxcephalosporin-180714171228.pptx
cephalosporin-180714171228.pptxRashmiShah46
 
Nt presentation
Nt presentationNt presentation
Nt presentationGeria26
 
Nt presentation
Nt presentationNt presentation
Nt presentationGeria26
 
Beta lactam nursing AHS.pptx
Beta lactam nursing  AHS.pptxBeta lactam nursing  AHS.pptx
Beta lactam nursing AHS.pptxVishruti Raikar
 
Presentation nt (1)
Presentation nt (1)Presentation nt (1)
Presentation nt (1)Geria26
 

Semelhante a Antibiotics(Cephalosporins • FluoroquinolonesTetracyclines) (20)

CEPHALOSPORINS
CEPHALOSPORINSCEPHALOSPORINS
CEPHALOSPORINS
 
Cephalosporins & beta lactams
Cephalosporins & beta lactamsCephalosporins & beta lactams
Cephalosporins & beta lactams
 
Cephalosporins
CephalosporinsCephalosporins
Cephalosporins
 
Cephalosporins pharmacology presentation
Cephalosporins pharmacology presentationCephalosporins pharmacology presentation
Cephalosporins pharmacology presentation
 
Cephalosporins & other β lactam antibiotics
Cephalosporins & other β lactam  antibioticsCephalosporins & other β lactam  antibiotics
Cephalosporins & other β lactam antibiotics
 
Cephalosporins penems
Cephalosporins  penemsCephalosporins  penems
Cephalosporins penems
 
cephalosporin-180714171228 (1). download
cephalosporin-180714171228 (1). downloadcephalosporin-180714171228 (1). download
cephalosporin-180714171228 (1). download
 
Cephalosporin Antibiotics
Cephalosporin AntibioticsCephalosporin Antibiotics
Cephalosporin Antibiotics
 
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6
CHEMOTHERAPY_RDP_G 4_CEPHALOSPORIN.pdf_SEM-6
 
Role Of Third And Fourth Generation Cephalosporin in ICU.pptx
Role Of Third And Fourth Generation Cephalosporin in ICU.pptxRole Of Third And Fourth Generation Cephalosporin in ICU.pptx
Role Of Third And Fourth Generation Cephalosporin in ICU.pptx
 
cephalosporin-180714171228.pptx
cephalosporin-180714171228.pptxcephalosporin-180714171228.pptx
cephalosporin-180714171228.pptx
 
Cephalosporine new
Cephalosporine newCephalosporine new
Cephalosporine new
 
Cephalosporins Pharmacology
Cephalosporins PharmacologyCephalosporins Pharmacology
Cephalosporins Pharmacology
 
Cephalosporins
CephalosporinsCephalosporins
Cephalosporins
 
Nt presentation
Nt presentationNt presentation
Nt presentation
 
Nt presentation
Nt presentationNt presentation
Nt presentation
 
Beta lactam nursing AHS.pptx
Beta lactam nursing  AHS.pptxBeta lactam nursing  AHS.pptx
Beta lactam nursing AHS.pptx
 
Cephalosporins
CephalosporinsCephalosporins
Cephalosporins
 
Presentation nt (1)
Presentation nt (1)Presentation nt (1)
Presentation nt (1)
 
Cephalosporins
CephalosporinsCephalosporins
Cephalosporins
 

Último

SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 

Último (20)

SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 

Antibiotics(Cephalosporins • FluoroquinolonesTetracyclines)

  • 2. Cephalosporin  Cephalosporins are grouped into "generations" by their antimicrobial properties. Cephalosporins are categorized  chronically, and are therefore divided into first, second, and third generations. Currently, three generations of  cephalosporins are recognized and a fourth has been proposed. Each newer generation of cephalosporins has  greater gram negative antimicrobial properties than the preceding generation. The later-generation  cephalosporins have greater effect against resistant bacteria.
  • 3. Cephalosporin  Cephalosporins are beta-lactam compounds in which the beta-lactam ring is fused to a 6-membered dihydrothiazine ring, thus forming the cephem nucleus. Side chain modifications to the cephem nucleus confers 1)an improved spectrum of antibacterial activity,2) pharmacokinetic advantages, and 3) additional side effects. Based on their spectrum of activity, cephalosporin's can be broadly categorized into four generations.
  • 5. Mechanism of action:  Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins) but are less susceptible to penicillinases. Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin-binding proteins (PBPs). PBPs bind to the D-Ala-D-Ala at the end of muropeptides (peptidoglycan precursors) to crosslink the peptidoglycan. Beta-lactam antibiotics mimic(অনুকরণপ্রিয়) the D-Ala-D-Ala site, thereby irreversibly inhibiting PBP crosslinking of peptidoglycan.
  • 6. CLASSIFICATION A. First Generation  Cephaloridine-Loridine, Ceporan  Cephalothin-Keflin  Cephalexin-Keflex, Ceporex  Cefazolin-Cefacidal  Cephradine-Velosef  Cepharpirin-Cefadyl  Cephadroxil-Doricef, Cefamox
  • 7. Second Generation  Cefaclor-Ceclor  Cefoxitin – Mefoxin  Cefuroxime – Zinacef, Zinnat  Cefonicid – Monocid  Cefotetan - Cefotan  Cefamdandole – Mandol  Cefprozil – Cefzil  Loracarbef – Lorabid  Cefmetazole – Zefazone  Ceforanide
  • 8. Third Generation  Cefotaxime – Claforan  Cefoperazone – Cefobid  Moxolactam – Moxam  Ceftizoxime – Cefizox  Ceftriaxone – Rocephin  Ceftazidime – Fortum  Cefotiam – Ceradolan  Cefixime – Suprax  Cefetamet – Globocef  Cefpodoxime – Vantin  Ceftibuten – Cedax  Cefdinir –Omnicef  Cefditoren
  • 9. Fourth Generation Cefepime – Maxipime Cefpirome – Cefrom
  • 10. CEFADROXIL Indication:  It has been successfully used for the treatment of upper respiratory tract infection.  It is also used in U.T.I.  Community acquired pneumonia(প্রনয়য়োয় োপ্রনয়ো) is well treated by cefadroxil.  It is effective against Gram-positive and Gram-negative organisms.
  • 11.  Contraindication:  It is not used in an individuals with porphyria(rare inherited or acquired disorder).  If the patient hypersensitive to cephalosporin.  Adverse effect:  Diarrhoea.  Nausea , Vomiting.  Allergic reaction may occur.  Blood disorders; including thrombocytopenia(abnormally low amount of platelets).  Leucopenia(Decrease of white blood cell).  Aplastic anemia(damage of bone marrow).
  • 12. Dose:  Adult: 500mg twice daily for skin, soft tissue and U.T.I.  Child: 250mg twice daily , soft tissue and U.T.I.(Age: 1-6 years). Brand Name:  Adora – Incepta.  Trubid –Opsonin.  Arocef –SK₊F.
  • 13. CEFALEXIN/CEPHALEXIN Indication:  It has highly activity against Gram-positive organisms and moderate activity against Gram-negative organism such as E.coli , Klebseilla and proteus.  It is useful for U.T.I. and R.T.I.  It is effective in Sinusitis and Skin and Soft tissue infection. Contraindication:  It should not be used in infection caused by H. influenza.  It should not used in Syphilis(sexually transmitted infection).  Cephalosporin hypersensitivity.
  • 14. Adverse effect:  Diarrhea, Vomiting.  Abdominal discomfort are relatively common.  Neurological disturbances may occur rarely. Dose:  Adult: 500mg twice daily for severe infection.  Child: 250mg twice daily for U.T.I. Prophylaxis of recurrent U.T.I , 125mg at night. Brand Name:  Ceporin – Square.  Keflin – Opsonin.  Alexin – Reneta.
  • 15. CEFOXITIN Indication:  It is effective against betalactamase producing strains of Haemophilus influenzae.  It is effective against Gram-negative organisms , except pseudomonas.  It can also be used in the treatment of U.T.I and lower respiratory tract infections.  It is useful in otitis ( কোয়নর িদোহ) media. Contraindication:  Hypersensitive to cephalosporin.  Porphyria.
  • 16. Adverse effect:  Diarrhea.  Nausea , Vomiting.  Allergic reaction may also occur.  GI upset. Dose:  200 – 400 mg daily in 1-2 divided dose.  Brand Name:  Cef-3−Square.  Cefid−Opsonin.  Rokim−SK₊F
  • 17. CEFDINIR Indication:  It is very active against Staphylococci , Streptococci and H. influenza.  It is used in the treatment of gonrrhoea ( sexuall transmitted infections).  It is also used in R.T.I. Contraindications:  Hypersensitive to cephalosporin.  Porphyria.
  • 18. Adverse effect:  Diarrhea.  Allergic reaction.  Gastrointestinal upset.  Uncomfortable abdomen. Dose:  200-400mg daily in 1-2 divided doses.  Brand Name:  Efdinir-Incepta.  Cednir-SK₊F.  Cefida-Beximco.
  • 19. CEFOTAXIME Indication:  It is widely used in in respiratory infection.  It is effective in meningitis( প্রিষ্ক প্রিল্লীর িদোহ).  It is used in the treatment of Typhoid fever , U.T.I.  It is useful in gonorrhoea and intra-abdominal sepsis. Contraindication:  Hypersensitive to cephalosporin.  Porphyria.
  • 20. Adverse effect:  Dermatological problem.  Hematological problem may occur.  Diarrhea.  Allergic reaction. Dose:  I.M,I.V 1-2g every 8hours depends on severity of infection. Brand Name:  Cefotax – Renata.  Maxcef – Square.  Taxim – Acme.
  • 21. CEFPODOXIME Indications:  It is used in upper respiratory tract infection.  It is used in the treatment of lower respiratory tract infection including bronchitis , pneumonia , skin and soft tissue infection.  It is used in the treatment of gonorrhoea. Contraindication:  Cephalosporin sensitivity.  Porphyria.
  • 22. Adverse effect:  GI upset.  Diarrhea.  Nausea , Vomiting.  Allergic reaction also occur. Dose:  100-200mg every 12hours for R.T.I. and U.T.I. Brand Name:  Vanprox – Square.  Vercef – Beximco.  Ximeprox – Incepta.  Cefdox – ACI.
  • 23. CEFTRIAXONE(INJ.) Indication:  It is effective in uncomplicated gonorrhoea and genital ulceration.  It has been commanded for the treatment of enteric fever.  It is also used in meningitis.  It is used in osteomyelitis (অপ্রির িদোহ). Contraindication:  Cephalosporin sensitivity.  Porphoria.
  • 24. Adverse effect:  Abdominal pain , Diarrhea.  Rush , fever.  Thrombocytopenia , thrombocytosis , leucopenia. Dose:  A single 250mg dose is effective for gonorrhoea and genital ulceration.  I.M , I.V 1 g/day as a single dose in moderate infaction. Brand Name:  Traxon – opsonon.  Arixon – Baximco.  Ceftron – Square.  Axon – Aristopharma.
  • 25. CEFEPIME(INJ.) Indication:  It is indicated for the treatment of serious infection due to organism resistance to cefotaxime.  It is used in the treatment of respiratory tract infection.  It is useful in gonorrhoea.  It is effective in enteric fever. Contraindication:  Hypersensitivity to cephalosporin.  Porphyria.
  • 26. Adverse effect:  Allergic reaction occurs.  Nausea , Vomiting.  GI upset. Dose:  I.V 2g of cefepime is given over 30min. Brand Name:  Xenim – Opsonin.  Ultrapime – Incepta.  Ceftipime – Reneta.
  • 27. MAFENIDE Indication:  It is used extensively in burns(second and third degree burn)  It is bacteriostatic against many Gram-positive and Gram- negative organisms.  Its capacity to inhibit carbonic anhydrous which could potentially result in metabolic acidosis(when body produce much acid or when the kidney remove enough acid). Contraindications:  Renal impairment.  Mefenide is contraindicated in those with sulfonamide hypersensitivity.
  • 28. Adverse effect:  Super infection.  Pain.  Rash.  Pruritus. Dose:  It should apply topically to a thickness of approx. 1.6mg to cleaned and debrided wound once or twice per day. Brand Name:  Mafanil.  Sulphamylar.  Sulfamylon.
  • 29. CEFTOBIPROLE Indications:  It is effective against MRSA.  It is also used in the treatment of complicated skin and skin structure infections.  It gives better result in community –acquired pneumonia (it is pneumonia acquired infectious from normal social contact)compared to ceptriaxone. Contraindications:  Hypersensitivity to cephalosporin.  Hepatic failure.  Renal impairment.
  • 30. Adverse effect:  Nausea  Diarrhea  Allergic reaction. Dose:  400 mg daily for MRSA. Brand Name:  Zeftera-UK,EU
  • 31. CEFTAROLINE FOSAMIL Indications:  It has activity against MRSA(Methicillin-resistant Staphylococcus aureus)  It is also used in treatment of complicated skin and skin structure infections.  It gives better result in community –acquired pneumonia compared to ceftriaxone. Contraindications:  Known serious hypersensitivity to ceftarolin.  Porphyria.
  • 32. Adverse effect:  Diarrhea.  Nausea.  Rush. Dose:  400mg daily for M.R.S.A.; in serve case it may be two time daily. Brand Name:  Teflaro in US.  Zinforo in Europe.
  • 33. Tetracyclines  - Tetracyclines are a group of broad-spectrum antibiotics  - They are natural product derived from Streptomyces sp  - Tetracyclines are so named for their four (tetra) hydrocarbon rings
  • 34. Tetracyclines  - The general usefulness of tetracyclines has been reduced with the onset of antibiotic resistance. Despite this, they remain the treatment of choice for some specific indications
  • 35. General Consideration - Source: Streptomyces grasius, a soil organism - Spectrum: Broad spectrum of activity i.e., active against both gm(+) and gm(-) bacteria - Mode of action: Bacteriostatic in nature - Mechanism of ACTION: Protein synthesis inhibition
  • 36. History  The development of the tetracycline antibiotics was the result of a systemic screening of soil specimens collected from many parts of the world for antibiotic- producing microorganisms. The first of these compounds chlortetracycline was introduced in 1948 followed by oxytetracycline and tetracycline in 1950 and 1952 respectively.
  • 37. Types  Tetracyclines are of two types:  1. Natural Tetracycline: (Short acting) - Chlortetracycline (S.aureofaciens ) - Oxytetracycline (S. rimosus ) - Demeclocycline (S. aureofaciens )
  • 38. Types  2. Semisynthetic Tetracycline: (long acting) -Doxycyclicline - Methecycline - Minocycline 3. Both natural and semisynthetic: -Tetracycline : Natural from S. grasius Semisynthetic from Chlortetracycline
  • 39. Mechanism of ActionTetracycline Enters into bacteria by -passive diffusion -Active transport Binds reversibly to receptor on the 30s ribosomal subunit Block the binding of charged aminoacyl tRNA to the ‘A’ site of the ribosome mRNA complex (-) addition of aminoacid in growing peptide chain (-) Protein synthesis (-) Bacterial growth & multiplication Note: At high conc. they can inhibit protein synthesis of mammal cell
  • 40. Mechanism of Tetracycline resistance >>The drug is not actively transported into the cell >>The drug leaves the cell so rapidly that the required conc. Of the drug is not maintained >>Enzymatic inactivation of tetracycline >>Production of protein that interferes binding of tetracycline to ribosome
  • 41. Therapeutic uses  Drug of first choice ●Rickettsial infection -Rocky mountain spotted fever -Typhus -Rickettsialpox ●Mycoplasma infection -Mycoplasma pneumonia ●Borrelia infection -Lyme disease -Relapsing fever ●Vibrio infection -Cholera ●Plague, brucellois ( with aminoglycoside)
  • 42. Therapeutic uses  Drug of second choice ●Diarrhoea ●Dysentery ●Mixed bacterial infection e.g. repiratory tract infection ●Acne ●SIADH (Syndrome of inappropriate ADH secretion) ●Leptospiral infection ●Tularemia (An acute plague like infectious disease Caused by Francisella tularensis transmitted to the human by the bite of an infected tick or other blood sucking insect ●Weils disease
  • 43. Adverse effect  A) Organ/ system toxicity ●GIT -Nausea -Vomiting -Diarrhoea -Alteration of intestinal flora ● Hepatotoxicity ●Nephrotoxicity (due to inhibition of protein synthesis) -Renal tubular acidosis -Nephrogenic diabetes insipidus -Fanconis syndrome ● Bony stucture and teeth: -Discoloration and hypoplasia of teeth ●Vestibular toxicity: -Dizziness -Vertigo
  • 44. Adverse effect  B) Super infection: -Candida or resistant staphylococci  C) Hypersensitivity: -Urticaria -Anaphylaxix -Angioedema
  • 45. Contraindication ●Pregnancy and lactation ●Young children ( upto 8 years) ●Renal failure ●History of hypersensitivity
  • 46. Oxytetracycline ● Indications: -treatment of Spirochaetal infection. -treatment of Non-Specific-Urethritis. -treatment of Clostridial wound infection and Anthrax. ●Contraindication: -Renal impairment -Pregnancy & breast feeding -SLE (Systemic lupus eryyhematosus) ●Side effects: -Local irritation after intramuscular injection. -Gastrointestinal:-anorexia, nausea, vomiting. -Renal toxicity. -Hypersensitivity reactions: Urticaria. -Blood: Hemolytic anemia, thrombocytopenia, neutropenia
  • 47. Oxytetracycline ●Dose: 250-500 mg every 6 hours ●Market preparations -Renamycin® (Renata) -Oxecylin® (ACME) -Oxycap® (Globe Pharma)
  • 48. Doxycycline ●Indications: -Treatment of chronic adult periodontitis. -Chronic prostatitis -Brucellosis ●Contraindication: -Renal impairment -Pregnancy & breast feeding -SLE (Systemic lupus eryyhematosus) ●Side effects: -Watery diarrhea -Bloody stools -photosensitivity, rash
  • 49. Doxycycline ●Dose: -By mouth 200 mg on first day, then 100 mg daily -In severe infections 200 mg daily for 4 days ●Market preparations: -Doxin (Opsoni) -Doxy-A (ACME) -Servidoxyne (Novartis)
  • 50. Tetracycline ●Indications: -Tetracycline's primary use is for the treatment of acne vulgaris and rosacea. -It is also used to treat a very wide range of infections. ●Contraindication: -Renal impairment -Pregnancy & breast feeding -SLE (Systemic lupus eryyhematosus) ●Side effects: -Superinfection -Enamel dysplasia -Impairment in bone growth
  • 51. Tetracycline ●Dose: -By mouth 250 mg every 6 hours -Increased in severe infections to 500 mg every 6-8 hours ●Market preparations: -Jmycin (Jayson) -Tetracycline (Opsonin) -Tetracyn (Renata) -Tetrax (Square)
  • 52. Fluoroquinolones  Fluoroquinolones are known as broad-spectrum antibiotics, meaning they are effective against many bacteria.  Fluoroquinolones are used to treat most common urinary tract infections, skin infections, and respiratory  infections (such as sinusitis, pneumonia, bronchitis). Common side effects of fluoroquinolones include mainly  the digestive system: mild stomach pain or upset, nausea, vomiting, and diarrhea. These are usually mild and go  away over time. Fluoroquinolones should not be given during pregnancy.  Fluoroquinolones inhibit bacteria by interfering with their ability to make DNA. This activity makes it difficult  for bacteria to multiply. This effect is bacteriocidal.
  • 53. Quinolones  The quinolones are family of synthetic broad spectrum antibacterial drugs  Quinolones exert their antibacterial effect by preventing bacterial DNA fom unwinding and duplicating  The majority of quinolones in clinical use belong to the subset fluroquinolones
  • 54. History  The first generation of quinolones began with the introduction of nalidixic acid in 1962 for treatment of urinary tract infections in humans. Nalidixic acid was discovered by George Lesher and coworkers in a distillate during an attempt at chloroquine synthesis.
  • 55. Types A) First generation: ●Non flurinated quinolone ●Narrow spectrum -Nalidixic acid B) Second generation: ● Flurinated quinolones, 6o times more active then nalidixic acid ●Broad spectrum ●Not effective against anaerobes and community acquired pneumonia caused by Streptococcus pneumoniae -Ciprofloxacin -Enoxacin -Lomefloxacin -Acrosoxzacin -Norfloxacin -Ofloxacin
  • 56. Types C) Third generation: ●Broad spectrum ●Effective against anaerobes and community acquired pneumonia caused by Streptococcus pneumoniae -Sparfloxacin -Levofloxacin D) Fourth generation: ●More effective against anaerobes and community acquired pneumonia caused by Streptococcus pneumoniae -Moxifloxacin -Trovafloxacin
  • 57. Mechanism of Action  Mechanism of action: -Inhibit bacterial DNA synthesis by inhibiting DNA gyrase and topo-isomerase IV resulting to rapid cell death -Post antibiotic effect: lasts 1 to 2 hours, increases with increasing concentration
  • 58. Mechanism of Action Quinolone Enter into cell via passive diffusion (-) Rejoining of DNA (-) Supercoiling of DNA Cell death Note: Quinolone (-) human DNA gyrase only at much higher conc. i.e., 100-1000 µ gm/ml
  • 59. Mechanism of Quinolone resistance ●Chromosomal: -Alter target enzymes: DNA gyrase and topoisomerase IV -Decreased drug penetration: Pseudomonas, E. coli ●Plasmid: seen in some K. pneumoniae and E. coli ●Mutations in both target enzymes are needed to produce significant resistance
  • 60. Therapeutic uses ●Urinary tract infections ●Gastrointestinal infections -Enteric fever -Bacillary dysentery -Septicaemia ●Respiratory tract infections (but not in pneumococcal pneumonia ●Gynecological infection ●Intraabdominal infection ●Severe systemic infection
  • 61. Adverse effect -Tendon inflammation -Arthralgia -Myalgia -Hypersensitivity reactions (sometimes involving blood cells -Photosensitivity -Nausea, Vomiting
  • 63. Nalidixic acid ●Indications: -In complicated UTI ●Contraindication: -Hypersensitivity to drug -Porphyria -Liver disease -Renal impairment ●Side effects: -Psychosis -Cranial nerve palsy -Metabolic acidosis
  • 64. Nalidixic acid ●Dose: By mouth 1g every 6hours for 7 days ●Market preparations: -Naligram® (ACME) -Nebactil® (Beximco) -Utirex® (Opsonin)
  • 65. Ciprofloxacin ●Indications: - Nosocomial pneumonia - Intra-abdominal infections -Uncomplicated/complicated UTI -Anthrax exposure and prophylaxis ●Contraindications: -Pregnant and lactating women -myasthenia gravis -Hypersensitivity ●Side effects: -CNS toxicity -GIT upset -Hypersensitivity
  • 66. Ciprofloxacin ●Dose By mouth, -In RTI 250-500 mg every 12 hours -In pseudomonal lower RTI 750 mg twice daily -In UTI 250-500 mg twice daily ●Market preparations: -Beuflox (Incepta) -Cipro-A (ACME) -Flontin (Renata) -Neofloxin XR (Beximco)
  • 67. Lomefloxacin ●Indications: -Treatment of bronchitis due to H. inflenzae -UTI ●Contraindications: -Pregnant and lactating women -myasthenia gravis -Hypersensitivity ●Side effects: -Phototoxicity -CNS toxicity -GIT upset -Hypersensitivity
  • 68. Lomefloxacin ●Dose: 400 mg once daily ●Market preparations: -Lomeflox (Aristopharma) -Mexio (Square) -Namicin (Nipa)
  • 69. Ofloxacin ●Indications: -UTI -Lower RTI -Gonrrhoea -Cervicitis ●Contraindications: -Hepatic and renal impairment -History of psychiatric illness ●Side effects: -Hypersensitivity reactions (sometimes involving blood cells
  • 70. Ofloxacin ●Dose: By mouth, -UTI: 200-400 mg daily in the morning. Increased upto 400 mg twice daily for upper UTI -Chronic prostatitis 200 mg twice daily for 28 days -Lower RTI 400 mg daily in the morning ●Market preparations: -Oflacin (Drug Intl.) -Rutix (Square)
  • 71. Levofloxacin ●Indications: -Chronic bronchitis and CAP - Nosocomial pneumonia -SSTIs -Intra-abdominal infections ●Contraindictions: -Renal impairment -Pregnant and lactating women -Children ●Side effects: -Asthenia -Rarely tremor -Anxiety -Tachycardia
  • 72. Levofloxacin ●Dose: Oral, -Acute sinusitis: 500mg daily for 10-14 days - -Exacerbation of chronic bronchitis: 250-500 mg daily for 7-10 days - -Community acquired pneumonia: 500 mg once or twice daily for 7-14 days ●Market preparations: -Evo (Beximco) -Exolev (Novartis) -Levoking (Renata) -Trevox (Square)
  • 73. Moxifloxacin ●Indications: -Chronic bronchitis -Bacterial conjuctivitis -Sinusitis ●Contraindications: -Should be avoided in patients with existing QT prolongation ●side effects: -CNS toxicity -GIT upset -Hypersensitivity
  • 74. Moxifloxacin ●Dose: Adult dose is 400 mg daily ●Market preparations: -Maximox (Orion) -Odycin (Beximco) -Optimox (aristopharma)